Thyagaturu Harshith S, Bolton Alexander R, Li Si, Gonuguntla Karthik, Kumar Amudha, Bianco Christopher, Balla Sudarshan
Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY.
University of Iowa College of Public Health, Iowa City, IA.
Curr Probl Cardiol. 2023 Aug;48(8):101189. doi: 10.1016/j.cpcardiol.2022.101189. Epub 2022 Mar 25.
There is limited evidence demonstrating whether cannabis, cocaine, amphetamine, or other stimulants use contributes to heart failure (HF) readmissions. We used the National Readmissions Database years 2016-2018 to identify patients with HF with and without substance use disorder (SUD) (defined as a composite of cannabis, cocaine, or other stimulant use disorders). The main outcome was to assess the risk of 30-day readmissions in HF patients with and without SUD. Of 978,217 HF hospitalizations that met the inclusion criteria, 34,717 (3.5%) had concomitant SUD. HF patients with SUD had significantly higher hazard for 30-day all-cause readmissions (adjusted hazard ratio [aHR] 1.16 [1.12-1.21]; P < 0.01) compared to HF patients without SUD. In conclusion, HF patients with SUD have an elevated risk of 30-day all-cause readmissions, mainly driven by cocaine and other stimulant disorders. Screening for substance use in hospitalized HF patients as well as timely referral for treatment are important to prevent HF readmissions.
关于大麻、可卡因、安非他命或其他兴奋剂的使用是否会导致心力衰竭（HF）再入院，现有证据有限。我们利用2016 - 2018年国家再入院数据库，确定患有和未患有物质使用障碍（SUD，定义为大麻、可卡因或其他兴奋剂使用障碍的综合情况）的HF患者。主要结果是评估患有和未患有SUD的HF患者30天再入院的风险。在符合纳入标准的978,217例HF住院病例中，34,717例（3.5%）伴有SUD。与没有SUD的HF患者相比，患有SUD的HF患者30天全因再入院的风险显著更高（调整后风险比[aHR]为1.16 [1.12 - 1.21]；P < 0.01）。总之，患有SUD的HF患者30天全因再入院风险升高，主要由可卡因和其他兴奋剂障碍所致。对住院HF患者进行物质使用筛查以及及时转诊治疗对于预防HF再入院很重要。
